The Burden and Determinants of Neck Pain in Whiplash-Associated Disorders After Traffic Collisions

Abstract

Study Design. Best evidence synthesis. Objective. To undertake a best evidence synthesis on the burden and determinants of whiplash-associated disorders (WAD) after traffic collisions.Summary of Background Data. Previous best evidence synthesis on WAD has noted a lack of evidence regarding incidence of and risk factors for WAD. Therefore there was a warrant of a reanalyze of this body of research. Methods.A systematic search of Medline was conducted. The reviewers looked for studies on neck pain and its associated disorders published 1980 -2006. Each relevant study was independently and critically reviewed by rotating pairs of reviewers. Data from studies judged to have acceptable internal validity (scientifically admissible) were abstracted into evidence tables, and provide the body of the best evidence synthesis.Results. The authors found 32 scientifically admissible studies related to the burden and determinants of WAD. In the Western world, visits to emergency rooms due to WAD have increased over the past 30 years. The annual cumulative incidence of WAD differed substantially between countries. They found that occupant seat position and collision impact direction were associated with WAD in one study. Eliminating insurance payments for pain and suffering were associated with a lower incidence of WAD injury claims in one study. Younger ages and being a female were both associated with filing claims or seeking care for WAD, although the evidence is not consistent. Preliminary evidence suggested that headrests/car seats, aimed to limiting head extension during rear-end collisions had a preventive effect on reporting WAD, especially in females.Conclusion. WAD after traffic collisions affects many people. Despite many years of research, the evidence regarding risk factors for WAD is sparse but seems to include personal, societal, and environmental factors. More research including, well-defined studies with accurate denominators for calculating risk, and better consideration of confounding factors, are needed.

The Burden and Determinants of Neck Pain in Workers

“…[15][16][17] This stratification distinguishes between 3 hierarchical phases of research aimed at determining "causal" relationships between a risk factor and a health outcome, and has been used elsewhere in the Neck Pain Task Force report. 5,[18][19][20][21] Phase I studies describe crude associations. Crude associations result from bivariate analyses (e.g., gender and neck pain) and are therefore potentially confounded.…”

Evaluation of eye, head and trunk coordination during target tracking tasks

“…The eye and head moved to a similar extent to reach the 40˚ target position, but the head moved more than the eye to reach the 70˚ target position (38˚ vs 24˚). It is likely that subjects with conditions, such as whiplash injuries, would present delayed response times, and reduced neck motion compared to healthy individuals due to possible coordination issues and neck limitations (Bexander and Hodges 2011;Treleaven Jull and Low Choy 2005;Holm et al 2008;Treleaven 2008). These limitations may help to explain the commonly reported driving difficulties (Pereira, Jull and Treleaven 2008;Takasaki et al 2011;Gimse, Bjorgen andStraume 1997, Takasaki et al, 2014).…”

Detecting fraudulent whiplash claims by support vector machines

“…The diagnosis of WAD is an archetype of the diagnosis of a soft tissue injury where the diagnosis is mainly based on the exclusion of visible trauma on standard imaging modalities [2]. Recent figures suggest that more than 300 persons (per 100 000 in the population) with neck pain after traffic collisions are seen in emergency departments every year [3,4]. Although the majority of those diagnosed with WAD recover within the first 3 months after injury [5], a significant proportion, 20-40% remain symptomatic at 6 months and develop chronic WAD [5,6].…”